Neurocognitive Reaction Time Predicts Lower Extremity Sprains and Strains

2012 ◽  
Vol 17 (6) ◽  
pp. 4-9 ◽  
Author(s):  
Gary B. Wilkerson

Context:Prevention of a lower extremity sprain or strain requires some basis for predicting that an individual athlete will sustain such an injury unless a modifiable risk factor is addressed.Objective:To assess the possible existence of an association between reaction time measured during completion of a computerized neurocognitive test battery and subsequent occurrence of a lower extremity sprain or strain.Design:Prospective cohort study.Setting:Preparticipation screening conducted in a computer laboratory on the day prior to initiation of preseason practice sessions.Participants:76 NCAA Division I-FCS football players.Main Outcome Measures:Lower extremity sprains and strains sustained between initiation of preseason practice sessions and the end of an 11-game season. Receiver operating characteristic analysis identified the optimal reaction time cut-point for discrimination between injured versus noninjured status. Stratified analyses were performed to evaluate any differential influence of reaction time on injury incidence between starters and nonstarters.Results:A total of 29 lower extremity sprains and strains were sustained by 23 of the 76 players. A reaction time cut-point of ≥ .545 s provided good discrimination between injured and noninjured cases: 74% sensitivity, 51% specificity, relative risk = 2.17 (90% CI: 1.10, 4.30), and odds ratio = 2.94 (90% CI: 1.19, 7.25).Conclusions:Neurocognitive reaction time appears to be an indicator of elevated risk for lower extremity sprains and strains among college football players, which may be modifiable through performance of exercises designed to accelerate neurocognitive processing of visual input.

2017 ◽  
Vol 26 (1) ◽  
pp. 26-34 ◽  
Author(s):  
Gary B. Wilkerson ◽  
Kevin A. Simpson ◽  
Ryan A. Clark

Context:Neurocognitive reaction time has been associated with musculoskeletal injury risk, but visuomotor reaction time (VMRT) derived from tests that present greater challenges to visual stimulus detection and motor response execution may have a stronger association.Objective:To assess VMRT as a predictor of injury and the extent to which improvement may result from VMRT training.Design:Cohort study.Setting:University athletic performance center.Participants:76 National Collegiate Athletic Association Division-I FCS football players (19.5 ± 1.4 y, 1.85 ± 0.06 m, 102.98 ± 19.06 kg).Interventions:Preparticipation and postseason assessments. A subset of players who exhibited slowest VMRT in relation to the cohort’s postseason median value participated in a 6-wk training program.Main Outcome Measures:Injury occurrence was related to preparticipation VMRT, which was represented by both number of target hits in 60 s and average elapsed time between hits (ms). Receiver operating characteristic analysis identified the optimum cut point for a binary injury risk classification. A nonparametric repeated-measures analysis of ranks procedure was used to compare posttraining VMRT values for slow players who completed at least half of the training sessions (n = 15) with those for untrained fast players (n = 27).Results:A preparticipation cut point of ≤85 hits (≥705 ms) discriminated injured from noninjured players with odds ratio = 2.30 (90% confidence interval, 1.05–5.06). Slow players who completed the training exhibited significant improvement in visuomotor performance compared with baseline (standardized response mean = 2.53), whereas untrained players exhibited a small performance decrement (group × trial interaction effect, L2 = 28.74; P < .001).Conclusions:Slow VMRT appears to be an important and modifiable injury risk factor for college football players. More research is needed to refine visuomotor reaction-time screening and training methods and to determine the extent to which improved performance values can reduce injury incidence.


2021 ◽  
Vol 9 (8) ◽  
pp. 232596712110322
Author(s):  
Jason M. Avedesian ◽  
Tracey Covassin ◽  
Shelby Baez ◽  
Jennifer Nash ◽  
Ed Nagelhout ◽  
...  

Background: Collegiate athletes with prior sports-related concussion (SRC) are at increased risk for lower extremity (LE) injuries; however, the biomechanical and cognitive mechanisms underlying the SRC-LE injury relationship are not well understood. Purpose: To examine the association between cognitive performance and LE land-and-cut biomechanics among collegiate athletes with and without a history of SRC and to determine the association among multiple cognitive testing batteries in the same athlete cohort. Study Design: Controlled laboratory study. Methods: A cohort of 20 collegiate athletes with prior SRC (9 men, 11 women; mean ± standard deviation [SD] age, 20.5 ± 1.3 years; mean ± SD time since last SRC, 461 ± 263 days) and 20 matched controls (9 men, 11 women; mean ± SD age, 19.8 ± 1.3 years) completed land-and-cut tasks using the dominant and nondominant limbs. LE biomechanical variables and a functional visuomotor reaction time (FVMRT) were collected during each trial. Athletes also completed the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) and Senaptec Sensory Station assessments. Results: In the SRC cohort, Pearson correlation coefficients indicated slower FVMRT was moderately correlated with decreased dominant limb ( r = –0.512) and nondominant limb ( r = –0.500) knee flexion, while increased dominant limb knee abduction moment was moderately correlated with decreased ImPACT Visual Memory score ( r = –0.539) and slower ImPACT Reaction Time ( r = 0.515). Most computerized cognitive measures were not associated with FVMRT in either cohort ( P > .05). Conclusion: Decreased reaction time and working memory performance were moderately correlated with decreased sagittal plane knee motion and increased frontal plane knee loading in collegiate athletes with a history of SRC. The present findings suggest a potential unique relationship between cognitive performance and LE neuromuscular control in athletes with a history of SRC injury. Last, we determined that computerized measures of cognitive performance often utilized for SRC management are dissimilar to sport-specific cognitive processes. Clinical Relevance: Understanding the relationship between cognitive performance and LE biomechanics in athletes with prior SRC may inform future clinical management strategies. Future research should prospectively assess cognitive and biomechanical measures, along with LE injury incidence, to identify mechanisms underlying the SRC-LE injury relationship.


2015 ◽  
Vol 50 (6) ◽  
pp. 643-650 ◽  
Author(s):  
Gary B. Wilkerson ◽  
Marisa A. Colston

Context Researchers have identified high exposure to game conditions, low back dysfunction, and poor endurance of the core musculature as strong predictors for the occurrence of sprains and strains among collegiate football players. Objective To refine a previously developed injury-prediction model through analysis of 3 consecutive seasons of data. Design Cohort study. Setting National Collegiate Athletic Association Division I Football Championship Subdivision football program. Patients or Other Participants For 3 consecutive years, all 152 team members (age = 19.7 ± 1.5 years, height = 1.84 ± 0.08 m, mass = 101.08 ± 19.28 kg) presented for a mandatory physical examination on the day before initiation of preseason practice sessions. Main Outcome Measure(s) Associations between preseason measurements and the subsequent occurrence of a core or lower extremity sprain or strain were established for 256 player-seasons of data. We used receiver operating characteristic analysis to identify optimal cut points for dichotomous categorizations of cases as high risk or low risk. Both logistic regression and Cox regression analyses were used to identify a multivariable injury-prediction model with optimal discriminatory power. Results Exceptionally good discrimination between injured and uninjured cases was found for a 3-factor prediction model that included equal to or greater than 1 game as a starter, Oswestry Disability Index score equal to or greater than 4, and poor wall-sit–hold performance. The existence of at least 2 of the 3 risk factors demonstrated 56% sensitivity, 80% specificity, an odds ratio of 5.28 (90% confidence interval = 3.31, 8.44), and a hazard ratio of 2.97 (90% confidence interval = 2.14, 4.12). Conclusions High exposure to game conditions was the dominant injury risk factor for collegiate football players, but a surprisingly mild degree of low back dysfunction and poor core-muscle endurance appeared to be important modifiable risk factors that should be identified and addressed before participation.


2021 ◽  
pp. bjsports-2020-103159
Author(s):  
Jan Ekstrand ◽  
Armin Spreco ◽  
Håkan Bengtsson ◽  
Roald Bahr

BackgroundThe UEFA Elite Club Injury Study is the largest and longest running injury surveillance programme in football.ObjectiveTo analyse the 18-season time trends in injury rates among male professional football players.Methods3302 players comprising 49 teams (19 countries) were followed from 2000–2001 through 2018–2019. Team medical staff recorded individual player exposure and time-loss injuries.ResultsA total of 11 820 time-loss injuries were recorded during 1 784 281 hours of exposure. Injury incidence fell gradually during the 18-year study period, 3% per season for both training injuries (95% CI 1% to 4% decrease, p=0.002) and match injuries (95% CI 2% to 3% decrease, p<0.001). Ligament injury incidence decreased 5% per season during training (95% CI 3% to 7% decrease, p<0.001) and 4% per season during match play (95% CI 3% to 6% decrease, p<0.001), while the rate of muscle injuries remained constant. The incidence of reinjuries decreased by 5% per season during both training (95% CI 2% to 8% decrease, p=0.001) and matches (95% CI 3% to 7% decrease, p<0.001). Squad availability increased by 0.7% per season for training sessions (95% CI 0.5% to 0.8% increase, p<0.001) and 0.2% per season for matches (95% CI 0.1% to 0.3% increase, p=0.001).ConclusionsOver 18 years: (1) injury incidence decreased in training and matches, (2) reinjury rates decreased, and (3) player availability for training and match play increased.


2014 ◽  
Vol 23 (2) ◽  
pp. 107-122 ◽  
Author(s):  
W. Matthew Silvers ◽  
Eadric Bressel ◽  
D. Clark Dickin ◽  
Garry Killgore ◽  
Dennis G. Dolny

Context:Muscle activation during aquatic treadmill (ATM) running has not been examined, despite similar investigations for other modes of aquatic locomotion and increased interest in ATM running.Objectives:The objectives of this study were to compare normalized (percentage of maximal voluntary contraction; %MVC), absolute duration (aDUR), and total (tACT) lower-extremity muscle activity during land treadmill (TM) and ATM running at the same speeds.Design:Exploratory, quasi-experimental, crossover design.Setting:Athletic training facility.Participants:12 healthy recreational runners (age = 25.8 ± 5 y, height = 178.4 ± 8.2 cm, mass = 71.5 ± 11.5 kg, running experience = 8.2 ± 5.3 y) volunteered for participation.Intervention:All participants performed TM and ATM running at 174.4, 201.2, and 228.0 m/min while surface electromyographic data were collected from the vastus medialis, rectus femoris, gastrocnemius, tibialis anterior, and biceps femoris.Main Outcome Measures:For each muscle, a 2 × 3 repeated-measures ANOVA was used to analyze the main effects and environment–speed interaction (P ≤ .05) of each dependent variable: %MVC, aDUR, and tACT.Results:Compared with TM, ATM elicited significantly reduced %MVC (−44.0%) but increased aDUR (+213.1%) and tACT (+41.9%) in the vastus medialis, increased %MVC (+48.7%) and aDUR (+128.1%) in the rectus femoris during swing phase, reduced %MVC (−26.9%) and tACT (−40.1%) in the gastrocnemius, increased aDUR (+33.1%) and tACT (+35.7%) in the tibialis anterior, and increased aDUR (+41.3%) and tACT (+29.2%) in the biceps femoris. At faster running speeds, there were significant increases in tibialis anterior %MVC (+8.6−15.2%) and tACT (+12.7−17.0%) and rectus femoris %MVC (12.1−26.6%; swing phase).Conclusion:No significant environment–speed interaction effects suggested that observed muscle-activity differences between ATM and TM were due to environmental variation, ie, buoyancy (presumed to decrease %MVC) and drag forces (presumed to increase aDUR and tACT) in the water.


2017 ◽  
Vol 52 (10) ◽  
pp. 955-965 ◽  
Author(s):  
Zachary Y. Kerr ◽  
Susan W. Yeargin ◽  
Aristarque Djoko ◽  
Sara L. Dalton ◽  
Melissa M. Baker ◽  
...  

Context: Whereas researchers have provided estimates for the number of head impacts sustained within a youth football season, less is known about the number of plays across which such impact exposure occurs.Objective: To estimate the number of plays in which youth football players participated during the 2013 season and to estimate injury incidence through play-based injury rates.Design: Descriptive epidemiology study.Setting: Youth football.Patients or Other Participants: Youth football players (N = 2098; age range, 5−15 years) from 105 teams in 12 recreational leagues across 6 states.Main Outcome Measure(s): We calculated the average number of athlete-plays per season and per game using independent-samples t tests to compare age groups (5–10 years old versus 11–15 years old) and squad sizes (&lt;20 versus ≥20 players); game injury rates per 1000 athlete-exposures (AEs) and per 10 000 athlete-plays; and injury rate ratios (IRRs) with 95% confidence intervals (CIs) to compare age groups.Results: On average, youth football players participated in 333.9 ± 178.5 plays per season and 43.9 ± 24.0 plays per game. Age groups (5- to 10-year-olds versus 11- to 15-year-olds) did not differ in the average number of plays per season (335.8 versus 332.3, respectively; t2086.4 = 0.45, P = .65) or per game (44.1 versus 43.7, respectively; t2092.3 = 0.38, P = .71). However, players from smaller teams participated in more plays per season (373.7 versus 308.0; t1611.4 = 8.15, P &lt; .001) and per game (47.7 versus 41.4; t1523.5 = 5.67, P &lt; .001). Older players had a greater game injury rate than younger players when injury rates were calculated per 1000 AEs (23.03 versus 17.86/1000 AEs; IRR = 1.29; 95% CI = 1.04, 1.60) or per 10 000 athlete-plays (5.30 versus 4.18/10 000 athlete-plays; IRR = 1.27; 95% CI = 1.02, 1.57).Conclusions: A larger squad size was associated with a lower average number of plays per season and per game. Increasing youth football squad sizes may help reduce head-impact exposure for individual players. The AE-based injury rates yielded effect estimates similar to those of play-based injury rates.


2014 ◽  
Vol 23 (4) ◽  
pp. 319-329
Author(s):  
Randy J. Schmitz ◽  
John C. Cone ◽  
Timothy J. Copple ◽  
Robert A. Henson ◽  
Sandra J. Shultz

Context:Potential biomechanical compensations allowing for maintenance of maximal explosive performance during prolonged intermittent exercise, with respect to the corresponding rise in injury rates during the later stages of exercise or competition, are relatively unknown.Objective:To identify lower-extremity countermovement-jump (CMJ) biomechanical factors using a principal-components approach and then examine how these factors changed during a 90-min intermittent-exercise protocol (IEP) while maintaining maximal jump height.Design:Mixed-model design.Setting:Laboratory.Participants:Fifty-nine intermittent-sport athletes (30 male, 29 female) participated in experimental and control conditions.Interventions:Before and after a dynamic warm-up and every 15 min during the 1st and 2nd halves of an individually prescribed 90-min IEP, participants were assessed on rating of perceived exertion, sprint/cut speed, and 3-dimensional CMJ biomechanics (experimental). On a separate day, the same measures were obtained every 15 min during 90 min of quiet rest (control).Main Outcome Measures:Univariate piecewise growth models analyzed progressive changes in CMJ performance and biomechanical factors extracted from a principal-components analysis of the individual biomechanical dependent variables.Results:While CMJ height was maintained during the 1st and 2nd halves, the body descended less and knee kinetic and energetic magnitudes decreased as the IEP progressed.Conclusions:The results indicate that vertical-jump performance is maintained along with progressive biomechanical changes commonly associated with decreased performance. A better understanding of lower-extremity biomechanics during explosive actions in response to IEP allows us to further develop and individualize performance training programs.


2020 ◽  
Vol 2 (1) ◽  
pp. 61-67
Author(s):  
Maxwell Larwch ◽  
◽  
Jonathan Quartey ◽  
Samuel Koranteng Kwakye ◽  
◽  
...  

BackgroundThe increased popularity of football in addition to the physical and mental demands placed on players increase the risk of soccer injuries. We set out to identify injury patterns among footballers involved in selected Glo sponsored Ghana premier league games during the 2009/2010 season.MethodologyDigital video compact discs (DVDs) of thirty randomly selected 2009/2010 matches were acquired for the study from the Ghana Football Association. A Samsung DVD player and television set were used to playback and watch the matches. The researchers stopped the video immediately an injury occurred and the disc was then put in slow playback movement whilst the occurrence of injury was recorded on an injury report form.All statistical analyses were performed using SPSS version 20.ResultsA total of 139 injuries were recorded during the study with an average injury incidence of 4.63±1.99 injuries per match. Tackling attempts (51.1%) was the predominant mechanism of injury with the ankle (26.6%) being the most injured body part. There was a significant association between player position and number of injuries suffered (p=0.038) and a significant association observed between player position and severity of injuries (p = 0.042). The uses of icepack (34.5%) and vapocoolant spray (32.4%) were the most common first aid treatment for the injuries sustained.ConclusionThe study indicated that professional football players in Ghana are exposed to high injury risks as evident by the relatively high injury incidence. Keywords: Football, footballers,playback, injuries, digital video compact discs


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